Strategie léčby komorových tachykardií po infarktu myokardu a u dalších strukturálních srdečních chorob. Arytmická bouře.

• Main Author: Segeťová, Markéta
• Other Authors: Bytešník, Jan
• Format: Doctoral Thesis
• Language: Czech
• Published: 2012
• Online Access: http://www.nusl.cz/ntk/nusl-439783

Aims: Electrical storm (ES) adversely affects prognosis of patients with structural heart disease and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Frequent episodes of polymorphic ventricular tachycardias/ventricular fibrillation (VT/VF) in patients with coronary artery disease can be triggered by monomorphic ventricular premature beats (VPBs) and thus, amenable to catheter ablation. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES. Methods: Fifty consecutive patiens (age 59±13 years, 8 female) with coronary artery disease (38), idiopathic dilated cardiomyopathy (5), arrhythmogenic right ventricular cardiomyopathy (6), and/or with combined aetiology (1) underwent CA for ES. Mean left ventricular ejection fraction (LVEF) was 29 ± 11%. All patients underwent electroanatomical mapping, and CA was performed to abolish all inducible ventricular arrhythmias. Catheter ablation of electrical storm due to focally triggered polymorphic VT/VF was performed in nine patients. All 9 patients had previous myocardial infarction (MI) (interval of 3 days to 171 months). Electrical storm appeared either early after MI (till 1 month, group 1, n=5) or later (more than 1 month, group 2, n=4). Results: The ES was suppressed...